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Abstract Introduction Healthcare organizations experience difficult challenges as a result of nursing staff turnover. This is because it not only interrupts continuity of service but also its financial implications. Aim The purpose of the study was to find out the effects of work engagement on nurses' intentions to leave their jobs while considering resilience as a mediating factor. Methods The study used a descriptive-analytical design using a survey questionnaire on nurses working in different healthcare settings. The Utrecht Work Engagement Scale, the Brief Resilience Scale, and the Turnover Intention Scale were among the validated scales that were employed. The hypothesized relations were tested using descriptive and mediation analyses at a significance of

Abstract Background Sexual well-being is a key part of being human yet often remains shrouded in secrecy and poorly addressed in the clinical setting. The impact of burns and its long-term sequelae often lead to concerns regarding body image disturbance, self-esteem issues, and interpersonal challenges which can impact on an individual’s sexual well-being. However, existing post-burn rehabilitation programmes usually lack components addressing concerns regarding sexual well-being. As a part of a larger project, we developed a nurse-led aftercare programme, and this study sought to examine the effects of the programme in addressing the post-burn sexual well-being of adult burn survivors. Methods A randomised controlled trial approach was used. Sixty burn survivors aged ≥ 18 years with burn size ≥ 10% total burn surface area were assigned to intervention and control groups. Participants in the intervention group underwent the nurse-led aftercare programme which involved pre-discharge support and proactive follow-up support over 8 weeks. The sexuality subscale of the Burn Specific Health Scale-Brief was used to evaluate the outcome of interest. Data were collected at three timepoints: baseline (T0), post-intervention (T1), and follow-up (T2). Results Using a corrected p value of 0.017, the study observed only statistically significant time effect at both T1 and T2. Both group and interaction effects were statistically insignificant for this outcome. Conclusion Issues regarding sexual well-being are often considered sacred and may be challenging to discuss. Thus, a longer duration of the intervention may be considered with ongoing training of practitioners to identify and resolve emerging challenges. Despite the non-significant interaction and group effects, including sexual well-being support in post-burns rehabilitation programmes will facilitate access to and utilisation of the service among burn survivors who may need it. Trial registration Prospectively registered on 14th August 2020. ClinicalTrials.govNCT04517721.

Abstract BackgroundThe aging population highlights the need to maintain both physical and psychological well-being. Frailty, a multidimensional syndrome, increases vulnerability to adverse outcomes. Although physical exercise is effective, adherence among older adults with frailty is often low due to barriers. Motion-based video games (MBVGs) may enhance motivation and engagement. ObjectiveThis study aims to evaluate the effect of individualized exercise programs that combine MBVGs, intergenerational support, and therapeutic frameworks on physical, cognitive, and social frailty outcomes in community-dwelling older adults. MethodsThis randomized controlled trial was conducted from March 2022 to October 2023 across 6 community centers in Hong Kong. Participants aged 60 years and above with mild neurocognitive disorder were recruited, screened, and randomly assigned to either an intervention (n=101) or control group (n=101). The intervention included an 18-week program with 12 supervised exercise sessions utilizing motion-based technology, led by occupational therapists and assisted by youth volunteers. Data were collected at baseline (T1) and postintervention (T2), focusing on physical, cognitive, and social frailty outcomes, as well as client-related metrics. Statistical analyses were performed using SPSS, with significance set at P ResultsA total of 202 participants were recruited, with a mean age of 78.8 years (SD 7.8). Both groups showed improvements in balance from T1 to T2, with a significant time effect (βPβPβPβP ConclusionsThe growing aging population necessitates innovative strategies to support aging in place. Results indicated statistically significant improvements only in BMI and cognition, while other outcomes such as loneliness, balance, and eHealth literacy showed positive trends but lacked significance. Despite the limitations observed, particularly regarding the role of volunteer support and the diverse needs of community-dwelling older adults, the findings contribute to the foundation for future research aimed at enhancing biopsychosocial outcomes. Future studies should explore tailored interventions that consider individual preferences and abilities, as well as evaluate specific components of motion-based video games to optimize their effectiveness.

BackgroundThe wearable monitoring device (WMD) is emerging as a promising tool for community-dwelling older adults to monitor personal health, enhance awareness of their activities, and promote healthy behaviors. However, the sustained use of WMDs among this population remains a significant challenge. ObjectiveThis study aims to implement an interventional program that promotes and motivates the continued use of WMDs among older adults through a peer and professional support approach. This program will facilitate the integration of WMDs into their daily lives. MethodsThis feasibility trial examined the following: (1) the usability of the WMD from the users’ perspectives; (2) the feasibility of the Live With Wearable Monitoring Device program; and (3) the effectiveness of the Live With Wearable Monitoring Device program among community-dwelling older adults. The intervention, based on Self-Determination Theory, involved using the Live With Wearable Monitoring Device program over a 3-month period, with ongoing professional and peer support provided by community health workers, aided by a nurse and social workers. This support included 1 home visit and biweekly communication via WhatsApp. Data were collected at baseline and at 1, 3, and 6 months. ResultsA total of 39 participants were enrolled in the intervention group, while 37 participants were in the control group. The recruitment rate was high (76/89, 85%), and the attrition rate was low (8/76, 11%), indicating that the program is feasible for older adults. Participants in the intervention group exhibited higher self-efficacy, lower anxiety levels, and used the smartwatch more frequently, in terms of both days and hours, compared with the control group. A between-group difference was observed in self-efficacy between the intervention and control groups (β=3.31, 95% CI 0.36-6.25, P=.03), with statistically significant higher mean values recorded at all 4 time points. ConclusionsIt is clear that merely providing a WMD to older adults does not guarantee its usage, particularly for those unfamiliar with how to utilize its health-related functions in their daily routines. This study implemented a theory-based program aimed at enhancing the ongoing use of WMDs among older adults, suggesting that continuous professional and peer support may significantly influence WMD usage. Trial RegistrationClinicalTrials.gov NCT05269303; https://clinicaltrials.gov/ct2/show/NCT05269303

Abstract Background As the population ages, a plethora of digital and mobile health applications for assistance with independent living have emerged. Still unknown, however, is how older adults sustain the use of these applications. Aim This study sought to explore the experiences of older adults following their participation in a programme that combined the use of an mHealth application with proactive telecare nursing support. Methods We employed a concurrent mixed-methods design for this study. The quantitative strand included a survey, whereas the qualitative strand included open-ended questions as part of the survey to understand the participants’ experiences. Participants for this study were community-dwelling older adults who had taken part in an interventional study that sought to examine the effects of mHealth and nurse support. A convenience sampling approach was employed to recruit potential participants for this study. Findings : Fifty-five older adults participated. The majority expressed positive attitudes and satisfaction with the app and the nurses’ support. The app and nurses’ support helped participants to understand their health status and obtain health information. Reasons to halt app usage included technical issues and limited social support. Conclusion Mobile apps with professional follow-up support could potentially support older adults in the community, although emerging concerns need to be addressed to sustain long-term usage of these apps.

Abstract Background There was a substantial documented call for healthcare professionals to provide compassionate care during the COVID-19 pandemic and significant criticism voiced when it was lacking. This study aimed to explore perspectives on compassionate care among healthcare professionals providing care during the COVID-19 pandemic. The study focuses on healthcare professionals who participated in a wide range of COVID-19 measures, including testing, quarantine, diagnosis, and care provision (patients with COVID-19 or patients with other illnesses and comorbid with COVID-19). Methods A qualitative design with an interpretative phenomenological analysis approach was used. Twenty frontline healthcare professionals (15 nurses and five physicians) who had worked in COVID-19 facilities in China were interviewed individually. Results Participants stated that a commitment to ‘offering oneself’ and ‘balancing the advantages/disadvantages’ in providing care during the pandemic were key to alleviate population-level suffering. On a personal level, they described a desire for obtaining ‘mutual support’ and improving ‘professional competencies’ to safeguard their physical and mental well-being. Two professional competencies were notable: coping with grief and implementing infection control across the organization. Additionally, they emphasized the importance of receiving support from the health care organization, the public, and leaders in creating an ‘environment conducive to fostering compassionate care.’ Conclusion Healthcare professionals recognized the centrality of compassionate care during the pandemic which entailed a commitment to offering themselves, the balancing of advantages and disadvantages in order to find the best solution, as well as the need to safeguard themselves using professional competencies. Such findings can enrich the contemporary understanding of compassion, including when it is lacking. Support from the healthcare organization, the public, and leadership were crucial in fostering compassionate care in healthcare professionals during the pandemic and in moving the field forward in the future.

BackgroundThe use of wearable monitoring devices (WMDs), such as smartwatches, is advancing support and care for community-dwelling older adults across the globe. Despite existing evidence of the importance of WMDs in preventing problems and promoting health, significant concerns remain about the decline in use after a period of time, which warrant an understanding of how older adults experience the devices. ObjectiveThis study aims to explore and describe the experiences of community-dwelling older adults after receiving our interventional program, which included the use of a smartwatch with support from a community health workers, nurses, and social workers, including the challenges that they experienced while using the device, the perceived benefits, and strategies to promote their sustained use of the device. MethodsWe used a qualitative descriptive approach in this study. Older adults who had taken part in an interventional study involving the use of smartwatches and who were receiving regular health and social support were invited to participate in focus group discussions at the end of the trial. Purposive sampling was used to recruit potential participants. Older adults who agreed to participate were assigned to focus groups based on their community. The focus group discussions were facilitated and moderated by 2 members of the research team. All discussions were recorded and transcribed verbatim. We used the constant comparison analytical approach to analyze the focus group data. ResultsA total of 22 participants assigned to 6 focus groups participated in the study. The experiences of community-dwelling older adults emerged as (1) challenges associated with the use of WMDs, (2) the perceived benefits of using the WMDs, and (3) strategies to promote the use of WMDs. In addition, the findings also demonstrate a hierarchical pattern of health-seeking behaviors by older adults: seeking assistance first from older adult volunteers, then from social workers, and finally from nurses. ConclusionsOngoing use of the WMDs is potentially possible, but it is important to ensure the availability of technical support, maintain active professional follow-ups by nurses and social workers, and include older adult volunteers to support other older adults in such programs.

Abstract Background Men with breast cancer experience unique physical and emotional challenges. However, a thorough understanding of these experiences including the psychosocial effects and supportive care needs have received less attention. In some settings, men with breast cancer experience stigma within the healthcare system and their care needs are not prioritised. This influences the level of professional support offered, consequently worsening their health and well-being outcomes. This review explored the variabilities in the experiences and treatment modalities of male breast cancer (MBC) across different contexts. Methods All primary study designs including qualitative, quantitative, and mixed methods studies that reported on the experiences, treatment approaches and outcomes of MBC were included in this systematic review. Six databases (Embase, Medline, PsycINFO, Global Health, CINAHL and Web of Science) were searched for articles from January 2000 to September 2023. A results-based convergence synthesis was used for data analysis and reported using PRISMA guidelines. Results Of the studies screened (n = 29,687), forty-four fulfilled the predetermined criteria and were included. Our findings relating to the experiences and treatment approaches of MBC are broadly themed into three parts. Theme 1—Navigating through a threat to masculinity: describes how males experienced the illness reflecting on detection, diagnosis, coming to terms with breast cancer, and disclosure. Theme 2- Navigating through treatment: captures the experiences of undergoing breast cancer treatment/ management following their diagnosis. Theme 3—Coping and support systems: describes how MBC patients coped with the disease, treatment process, aftercare/rehabilitative care, and the available support structures. Conclusions Men experience a myriad of issues following a breast cancer diagnosis, especially with their masculinity. Awareness creation efforts of MBC among the public and healthcare practitioners are urgently required, which could change the perception of men in promoting early diagnosis, adherence to treatments, post-treatment monitoring, oncological results and a better quality of life. Considerations for training, education and development of specialised guidelines for healthcare practitioners on MBC would provide the necessary knowledge and skills to enhance their practice through the adoption of person-centred and male-specific care strategies. Professional care intervention and support for MBC should not end after the diagnosis phase but should extend to the entire treatment continuum and aftercare including future research focusing on MBC specific clinical trials. Trial registration PROSPERO Registration No. CRD42021228778.

Abstract The study compared perceived differences in Quality of Work‐Life (QoWL) among nurse clinicians and educators and coping strategies used by nurses. Design A cross‐sectional study. Methods From August and November 2020, the study measured the QoWL and coping strategies of 360 nurses with two scales using a multi‐stage sampling technique. The data were analysed with descriptive, Pearson correlation and multivariate linear regression analyses. Results Quality of Work‐Life was generally low among nurses; nurse educators, however, had better QoWL than clinical nurses. Age, salary and nature of work predicted the QoWL of nurses. Work‐family segmentation, seeking assistance, open communication and recreational activities were employed by most nurses to cope with challenges. With the rate of workload and work‐related stress associated with COVID‐19, nurse leaders must advocate for evidence‐based coping strategies to deal with work and family life stress.

Abstract Aims To identify the challenges facing burn care nurses and burn patients' family members and to explore the relationship between the above challenges. Design Whittemore and Knafl's integrative review. Methods Databases used for this review included Cochrane Library, Web of Science, PubMed and Embase. The original research published from January 2010 to November 2021 was selected. Studies reporting the challenges of family members or nurses of burn patients identified through extensive database search were considered for inclusion. The Mixed‐Method Appraisal‐Tool was applied for the evaluation of the quality of the literature. The analysis approach used was content analysis. Results Of the 2746 identified studies, 17 studies were included. Key findings related to the challenges facing nurses and family members of burn patients were extracted. The themes relating to burn care nurses included ethical and religious issues, clinical issues, work–life imbalance and limited support. The themes relating to family members included family's different views on prognosis and treatment, work–life imbalance, psychological issues and lack of multifaceted support. The challenges for the formal and informal caregivers are similar and there is existence of some shared concerns. If the above challenges are not resolved, support for the burn patients may be adversely affected. Corresponding measures should be taken to overcome such challenges.

A burn has been described as a family injury warranting the delivery of family-centered care (FCC) across the continuum of burns management. This assertion notwithstanding, only limited progress has been made to develop and implement FCC interventions in the burn unit. As a starting point, this study sought to formulate a tentative framework to underpin FCC in burn care. A multi-method design comprising an umbrella review and the secondary data analysis of qualitative datasets was employed. Following these, the findings were merged and aligned to the Universal Model of FCC to formulate the burn-specific FCC framework. For the umbrella review, four review articles met the criteria for inclusion. Following a data synthesis of the review findings and their integration with the qualitative dataset, four meta-themes that encapsulate the shared needs/concerns of family members of both pediatric and adult burn survivors emerged: (1) psychosocial concerns, (2) issues relating to role changes, (3) logistical concerns, and (4) requiring information. These issues were mapped to the following components of the Universal Model of FCC: family support, education, collaboration, and communication. All these are underpinned by dedicated policies, procedures, and consideration of the family context. Testing and further empirical work are needed to refine and implement the framework across the continuum of burn management.

BackgroundAdverse event reporting is crucial for improving patient safety and identifying areas for improvement in the emergency department. Many interventions have been employed in that regard, and have been found to increase adverse event reporting rates in various settings. All published research that studied the various interventions and their effectiveness on adverse event reporting in the Emergency Department will be reviewed in this paper.MethodsCINAHL, PubMed, Medline, Cochrane Reviews Library, EMBASE, Scopus, OVID, Science Direct and Web of Science will all be searched. Studies published since January 2000 that investigated the interventions to improve adverse event reporting will be included. Two independent reviewers will execute the selection and extraction process, and we will carry out a qualitative synthesis. A meta-analysis, if possible, will be undertaken.DiscussionThe present study will summarize interventions to improve adverse event reporting. It will also determine effective approaches to enhancing adverse event reporting in the emergency department. The outcome of the study will provide novel dimensions into possible interventions to improve patient safety through adverse event reporting.Systematic review registrationProtocol registration and reporting: PROSPERO CRD42023414795.

Abstract Introduction With the rise in global migration, hospitals and health systems in developed countries are looking to supplement their workforces with migrant nurses who have been reported to feel devalued, underutilized with experience of deskilling and unmet expectations as they transitioned. Despite the plethora of literature reporting on the experiences of internationally trained nurses, only limited work has been done regarding understanding the experiences of Migrant African nurses. Thus, this study sought to synthesize existing qualitative studies to develop in-depth understanding of the transitioning experiences of migrant African nurses, their career progression and to highlight existing gaps to guide future studies as well as inform policies. Method A meta-synthesis was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Enhancing transparency in reporting the synthesis of qualitative research statement. A pre-planned search strategy was developed guided by the SPIDER tool for qualitative synthesis searching EMBASE via OVID, CINAHL via EBSCO, PubMed, Web of Science, and PsychINFO databases. We included published studies that 1) focused on migrant African nurses, 2) employed a qualitative design and 3) reported in English. Results The search yielded 139 studies of which nine studies met the inclusion criteria and included in final synthesis. Three themes with corresponding subthemes emerged from data synthesis: 1) Navigating reality shock (a. Navigating a new culture, b. Survival strategies and support amidst the shock); 2) Discrimination and limited opportunities for promotion (a. Prejudices and preference for White over Black, b. Lack of recognition and limited opportunities for a workplace promotion); and 3) Finding one’s feet (a. Standing up for oneself and looking beyond discrimination, b. Experiencing growth). Conclusion Transitioning to a new setting can be a challenging experience for migrant African nurses warranting the availability of a tailor-made adaptation or orientation programme. Though African nurses may experience discrimination and prejudices as part of their transition, they consider their situation to be better off compared to back home. Therefore, clear transitioning policies which focus on career pathways are required by hiring institutions, and migrant nurses should be proactive in taking active roles in pushing their career ahead, instead of maintaining a culture of silence.

Abstract Background With today’s complex needs of the population and high demands in quality of care, there will be a continuing need for expanding role of nurses to assume more responsibilities in healthcare. Newly graduated nurses, who possess the competence to function as Registered Nurses, will soon recognize that lecture-based, passive delivery of content is not sufficient to deal with the complex healthcare environment. Aim This study aimed to compare the effects of a blended video watching and peer learning program and the usual lecture-based program on the levels of satisfaction and self-confidence in learning, perceptions of peer learning, and academic performance of students enrolled in a master’s nursing program. Methods A quasi-experimental study was conducted. The program was offered to Master of Science in Nursing students during Spring 2021 (intervention group, n = 46), while the usual face-to-face lectures and tutorial classes were provided to students enrolled during Fall 2020 (control group, n = 46). Results There was a statistically significant increase in satisfaction, self-confidence in learning, and academic performance in the intervention group after learning in a blended video-watching and peer learning mode. Conclusion This study fills a knowledge gap to meet the learning needs of time-conscious, part-time students working full time in hospitals.

Background Globally, nurse-led post-acute stroke clinics have been developed to provide secondary care services to stroke survivors. Although synthesized evidence supports the idea that the secondary prevention services delivered by nurses in these clinics can improve the functional ability of stroke survivors and reduce their readmission rates, long travel and waiting times, high costs, and the pandemic have limited the utilization of such clinics. Telecare consultations are a new modality for expanding public access to healthcare services, although how it can be applied in nurse-led clinics has not been reported. Objective The aim of this study is to determine the feasibility and effects of telecare consultations in nurse-led post-acute stroke clinics. Methods The study adopts a quasi-experimental design. The participants will receive three secondary stroke care consultations in 3 months provided via telecare by experienced advanced practice nurses. The outcome measures include feasibility (reasons for refusing to participate and for dropping-out, the attitudes and satisfaction of both the advanced practice nurses and their patients towards the programme), and preliminary effectiveness (degree of disability after stroke, activities of daily living, instrumental activities of daily living, health-related quality of life, depression) outcomes. Data will be collected at pre-(T1) and post-(T2) intervention. Conclusions The findings of this study may help facilitate the implementation of telecare consultations in a nurse-led post-acute stroke clinic, which may benefit the stroke survivors who are having mobility restrictions from accessing customary healthcare services and may protect them from being exposed to the infectious risk.

Abstract Aim To synthesize evidence on the concept of reassurance in nursing practice. Design Integrative review. Review Method PubMed, OVID MEDLINE, CINAHL and PsycINFO were searched from their inception to the 30 May 2020. The search results were screened. We assessed the quality of primary studies using the Mixed Method Appraisal Tool. Included studies were analysed using narrative synthesis. The review protocol was pre‐registered (PROSPERO‐CRD42020186962). Results Thirty‐two papers out of the 2,771 search results met our inclusion criteria. The synthesis of evidence generated three intricate themes, namely “antecedents of reassurance,” “defining attributes of reassurance” and “outcomes of reassurance.” Emotional distress was the main antecedent of reassurance. The three sub‐themes identified under defining attributes of reassurance include self‐awareness, emotional connectedness and verbal and non‐verbal techniques. Ultimately, reposing the confidence of patients and their families in healthcare professionals and the care delivery process to enable them to overcome their challenges constitutes the outcomes of reassurance.

Objective The ongoing pandemic has accentuated the use of telecare services; however, only limited progress has been made in understanding the barriers and facilitators to using these services. In order to move towards sustaining such essential services, the present study aimed to ascertain the experiences of stroke survivors and healthcare providers regarding the utilization of a post-stroke telecare service in Hong Kong. Methods Interpretive description was employed for this study. Semi-structured discussions and interviews were undertaken with nine stroke survivors and four stroke nurses who delivered the telecare services. The principles of thematic analysis were inductively followed to analyse the data. The Standards for Reporting Qualitative Research checklist was used to guide the reporting of the data. Results Three themes emerged: (a) pre-existing post-discharge service pathways; (b) push factors/facilitators for telecare usage; and (c) barriers to telecare usage. Overall, the telecare service was considered a significant alternative and one that complements conventional face-to-face follow-ups. Stroke survivors were motivated to use the service because it was convenient and flexible. However, significant barriers exist, including technical issues and a lack of guidelines and training opportunities for healthcare providers. Conclusions Although telecare is still evolving, several factors drive stroke survivors to use the service. Attention needs to be paid to the emerging barriers to improve long-term usage of the service. Clear guidelines are needed to underpin the development and implementation of telecare services.

BackgroundAlthough mobile health application (mHealth app) programs have effectively promoted disease self-management behaviors in the last decade, usage rates have tended to fall over time. ObjectiveWe used a case management approach led by a nurse and supported by a health-social partnership team with the aim of sustaining app usage among community-dwelling older adults and evaluated the outcome differences (i.e, self-efficacy, levels of depression, and total health service usages) between those who continued to use the app. MethodsThis was a 3-arm randomized controlled trial. A total of 221 older adults with hypertension, diabetes, or chronic pain were randomized into 3 groups: mHealth (n=71), mHealth with interactivity (mHealth+I; n=74), and the control (n=76). The mHealth application was given to the mHealth and mHealth+I groups. The mHealth+I group also received 8 proactive calls in 3 months from a nurse to encourage use of the app. The control group received no interventions. Data were collected at preintervention (T1), postintervention (T2), and at 3 months’ postintervention (T3) to ascertain the sustained effect. ResultsA total of 37.8% of mHealth+I and 18.3% of mHealth group participants continued using the mHealth app at least twice per week until the end of the sixth month. The difference in app usage across the 2 groups between T2 and T3 was significant (χ21=6.81, P=.009). Improvements in self-efficacy (β=4.30, 95% CI 0.25-8.35, P=.04) and depression levels (β=–1.98, 95% CI –3.78 to –0.19, P=.03) from T1 to T3 were observed in the mHealth group participants who continued using the app. Although self-efficacy and depression scores improved from T1 to T2 in the mHealth+I group, the mean values decreased at T3. Health service usage decreased for all groups from T1 to T2 (β=–1.38, 95% CI –1.98 to –0.78, P

SignificanceUsing mHealth apps alone at home without the support of healthcare experts could mean that older adults might not fully utilize the functions of the apps, recognize their benefits, and sustain their use. Incorporating an integrated health-social partnership model to support the app usage when further help is needed by the older adults might maximize the apps' benefits in the long term.ObjectivesThis study aimed to examine the benefits of adding nursing interaction supported by a health-social partnership model in the use of mHealth, and the sustained beneficial effects on psychological outcomes, including quality of life, self-efficacy, and depression, among older adults after the completion of the program.MethodsA three-arm, randomized controlled trial design was adopted. Community-dwelling older adults with chronic pain, hypertension, or diabetes, were randomly assigned to either the mHealth, mHealth with interactivity, or control group. Subjects in both the mHealth and the mHealth with interactivity groups received the mHealth application. In addition, the mHealth with interactivity group received support from a nurse case manager, who was supported by a health-social partnership team. mHealth apps and services from a nurse case manager were not provided to the control group. The primary outcome measure was quality of life, and secondary outcomes were self-efficacy and depression. Data were collected at pre-intervention (T1), post-intervention (T2), and at 3 months post-intervention to measure the sustained effect of the program.ResultsThere were 74 mHealth+I, 71 mHealth, and 76 control group subjects enrolled in the program. No statistically significant between-group, within-group, and interaction effects between group and time in both physical component summary (PCS) and mental component summary (MCS) scores were found among the three groups. The mHealth group showed an improvement in PCS and depression scores from T1 to T2, sustained at T3; while the mHealth+I group demonstrated improved self-efficacy from T1 to T2, with a decrease at T3.ConclusionAdding nurse-directed telephone calls may be of little to no benefit at all in the long term. Future studies may consider a longer intervention period to build and sustain quality of life and self-efficacy levels among community-dwelling older adults.Clinical trial registrationwww.ClinicalTrials.gov, identifier: NCT03878212.

BackgroundIn recent years, telehealth has become a common channel for health care professionals to use to promote health and provide distance care. COVID-19 has further fostered the widespread use of this new technology, which can improve access to care while protecting the community from exposure to infection by direct personal contact, and reduce the time and cost of traveling for both health care users and providers. This is especially true for community-dwelling older adults who have multiple chronic diseases and require frequent hospital visits. Nurses are globally recognized as health care professionals who provide effective community-based care to older adults, facilitating their desire to age in place. However, to date, it is unclear whether the use of telehealth can facilitate their work of promoting self-care to community-dwelling older adults. ObjectiveThis review aims to summarize findings from randomized controlled trials on the effect of nurse-led telehealth self-care promotion programs compared with the usual on-site or face-to-face services on the quality of life (QoL), self-efficacy, depression, and hospital admissions among community-dwelling older adults. MethodsA search of 6 major databases was undertaken of relevant studies published from May 2011 to April 2021. Standardized mean differences (SMDs) and their 95% CIs were calculated from postintervention outcomes for continuous data, while the odds ratio was obtained for dichotomous data using the Mantel–Haenszel test. ResultsFrom 1173 possible publications, 13 trials involving a total of 4097 participants were included in this meta-analysis. Compared with the control groups, the intervention groups of community-dwelling older adults significantly improved in overall QoL (SMD 0.12; 95% CI 0.03 to 0.20; P=.006; I2=21%), self-efficacy (SMD 0.19; 95% CI 0.08 to 0.30; P